336301267-1-15-2025-10-CC-WMCJ-DCXQHN-20250115111124

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 336301267
Report Date: 01/15/2025
Date Signed: 01/15/2025 11:13:00 AM

Document Has Been Signed on 01/15/2025 11:13 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME:	LEWIS FAMILY CHILD CARE		FACILITY NUMBER:	336301267
ADMINISTRATOR/ DIRECTOR:	LEWIS,AMANDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 784-9335
CITY:	TEMECULA	STATE: CA	ZIP CODE:	92592
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	01/15/2025
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:45 AM
MET WITH:	Amanda Lewis		TIME VISIT/ INSPECTION COMPLETED:	11:25 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On January 15, 2025, at 8:45AM, Licensing Program Analyst (LPA) William Chancellor arrived at the facility to conduct a pre-licensing inspection, due to a relocation. Present during this inspection were: Amanda Lewis and Michael Watanabe. The home has 5 bedrooms, 3 bathrooms, with attached garage. LPA toured the facility, inside and out with Amanda Lewis and the following was observed and/or discussed: · Per Applicant, off-limit areas include: attached garage, entire second story. Off-limit areas include child safety locks and gates, making them inaccessible to children. · Normal hours of operation will be: Monday- Friday 1AM-12AM. · Smoke detectors and Carbon Monoxide detectors were tested by the applicant during this inspection and were in working order. · There is central heating and air conditioning. · The fire extinguisher is fully charged and meets standards established by the State Fire Marshal. · All hazardous items were observed to be inaccessible. Storage of poisons and toxins are inaccessible to children and locked under kitchen sink, in upstairs laundry room and garage. Sharp items including kitchen knives, are inaccessible and stored in a locked kitchen cabinet drawer. Medicines are locked and stored in upstairs bedroom. · First Aid Kit is located in downstairs closet and contains all required items. · Guns or weapons are stored in the facility as of this date. LPA was unable to inspect firearms and ammunition on this date and inspection will be listed as a correction. Applicant understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations. · Stairs are barricaded. · The fireplace is properly screened indoors, the patio fireplace will be properly screened or barricaded during operation and listed as a correction. · Clean, safe and age-appropriate toys were not observed at this time, due to a current relocation of license. Licensee stated understanding of regulation and agrees age-appropriate toys will be inspected at a future date. · LPA observed a working telephone.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 336301267
	VISIT DATE: 01/15/2025

NARRATIVE

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·There were no toxic plants inside or outside the facility observed at this time. There are rose bushes and some aloe vera plants near the fence outdoors that will be enclosed and listed as a correction.
· The outside activity area consists of: enclosed backyard with two covered patio’s and grass. The outdoor space additionally has two side yards that is appropriately cemented and accessible to future daycare children.
· There are no bodies of water observed on this date. Applicant understands all bodies of water including ponds, above ground pools and spas, in-ground pools and spas, and some fountains must be properly covered or fenced per title 22 regulations. The Department must be notified before and after installation of the bodies of water described. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position when not in use.
· Applicant will not be transporting children.
· Verification of control of property has not been provided by applicant. Providing a rental agreement will be listed as a correction.
· Facility Sketch and Emergency Disaster Plan will be posted on the family board.
· Pediatric CPR and First Aid Card expires 8/2026.
· Mandated Reporter certificate expires 4/2026.
· Preventive Health and Safety training, including nutrition and lead components were completed on 5/2016.

Applicant was reminded all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

The applicant has not provided proof of control of property. Documentation of a grant, lease, mortgage statement or rental agreement will be provided as a correction.

Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC9149). LPA did confirm owner/landlord signed and agreed to terms of LIC 9149 and LIC 9151, authorizing consent on 12/8/24. However, during inspection Owner Michael Watanabe, verbally retracted authorization and stated they do not consent for Family Childcare and applicant Amanda Lewis has been given a thirty day notice of termination of tenancy.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 336301267
	VISIT DATE: 01/15/2025

NARRATIVE

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This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

On this date, 1/10/25, The California Attorney General – Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California’s Megan’s Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 336301267
	VISIT DATE: 01/15/2025

NARRATIVE

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The following items were also reviewed with the applicant during inspection:
- Failure to meet the posting requirements shall result in an immediate $100 civil penalty.
- Documentation of fire & earthquake drills to be conducted every six months
- Responsibilities of being a mandated reporter and updating training every 2 years
- Personal rights of children in care, including no corporal punishment
- Responsibility to know the Title 22 Regulations for anyone providing care and supervision
- Capacity and Supervision requirements
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility phone numbers must always be on file with the licensing office
- Baby walkers, bouncy seats, exer-saucers, and other similar items are prohibited
- Car seat law
- Smoking is prohibited in the facility while providing child care or transporting children
- Once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of
30 days. If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also
be posted for 30 days. A civil penalty of $100 per violation will be assessed for noncompliance.
- Applicant was informed of their reporting requirements and is provided with the Regional Office’s Unusual Incident Reporting email mailbox: UnusualIncidentReportsDO10@dss.ca.gov
-The Applicant can submit fingerprint transfer forms to associate new individuals or to disassociate someone from the facility at: Associations_Disassociations858@dss.ca.gov
- Access to forms & Title 22 Regulations for Family Child Care Homes online at www.ccld.ca.gov
- The Duty Officer is available to answer questions Monday – Friday 8:00am to 5:00pm at: 951-782-4200.

Before licensure, the following needs to be corrected/completed:
1. Provide photo of Parent Board with all required postings.
2. Remove clutter in entry way.
3. Consent for inspection of guns and ammunition was denied by landlord Michael Watanabe during inspection. Inspection of firearms and ammunition is required prior to licensure.
4. Install a barrier or partition to always make outdoors fireplace inaccessible to daycare children during operating hours.
5. Clear south side yard of hazards, including BBQ’s and deep fryer.
6. Enclose all aloe plants and rose bushes in outdoor’ s garden space.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: LEWIS FAMILY CHILD CARE	FACILITY NUMBER: 336301267
	VISIT DATE: 01/15/2025

NARRATIVE

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7. Remove tools such as rake and hammer, making them inaccessible to daycare children at all times.
8. Lower garden hose reel to the ground, reducing hazard of potential fall.
9. Install rubber bumpers to corners of dining room table and kitchen island. Creating extra barrier to prevent potential injury.
10. Cover or remove exposed cable and internet wires in the living room space.
11. Provide rental agreement from homeowner.

Once all corrections have been verified, the application for a Large Family Child Care Home will be submitted for approval with a maximum capacity of 14 with parent notification. Fire clearance was approved on January 9, 2025, authorizing operation and stating attached garage and entire upstairs as off limits. Applicant advised that all corrections are due within 30 days, or the application may be withdrawn.

Exit interview conducted and report was reviewed with the applicant, Amanda Lewis.

SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: William M Chancellor Jr.
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025

LIC809 (FAS) - (06/04)

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